COVID-19 Vaccine – Staging Environment
Availability, rollout and prioritization in Ontario New
When will primary care providers get the vaccine?
In Ontario’s plan, all healthcare workers have been identified as a priority population to be vaccinated in Phase 1, which is targeted to span from January to the end of March. Currently, vaccines are available to healthcare workers/essential caregivers who work in hospitals, long-term care homes, retirement homes, and other congregate settings caring for seniors.
Once all those in the highest priority level have been vaccinated, and as Ontario’s supply of vaccines increases over the coming weeks, the vaccine will be offered to the next priority level which includes primary care providers (MOH, February 9, 2021).
How can primary care providers support the vaccination effort?
In the current plan, vaccination in primary care practices is scheduled to begin in April with Phase 2.
Large primary care practices may be administering the vaccine as early as March. Phase 2 vaccinations would include the following patient groups:
- Older adults, beginning with those > 80 years of age and decreasing in five-year increments
- Individuals living and working in high-risk congregate settings
- Frontline essential workers (e.g., first responders, teachers, food processing industry)
- Individuals with high-risk chronic conditions and their caregivers
- Other populations and communities at greater risk of COVID-19
In anticipation of mass vaccination in Phase 2, the Ministry of Health is looking for healthcare providers to administer vaccines in both remote communities and large urban centres. You can register and apply through Ontario’s Matching Portal if you are a:
- Nurse practitioner, registered nurse or registered practical nurse
- Pharmacist, pharmacy student or intern or pharmacy technician
In the meantime, primary care providers can provide strong support to the vaccination effort by proactively engaging patients to bolster vaccine confidence. As the vaccination of healthcare workers is key to the larger vaccination effort, primary care providers should consider proactively reaching out to any patients who are healthcare providers to encourage them to be vaccinated.
- For tips on how to structure conversations about vaccination, see the PrOTCT Plan framework for vaccine discussion.
- For talking tips about specific vaccine questions, see Ensuring patient confidence in vaccines.
- CMPA has developed 2 resources on medical-legal questions surrounding vaccination. See COVID-19 vaccination: Medical-legal FAQ (CMPA, 2021) and How to address vaccine hesitancy and refusal by patients or their legal guardians (CMPA, 2020).
- Review and implement Engaging Indigenous Communities with COVID Vaccine Implementation (IPHCC) as appropriate to your practice area.
Distribution and logistics
Residents at all long-term care homes have been given an opportunity to receive their first dose of COVID-19 vaccine. In anticipation of a gradual increase in Ontario’s vaccine supply, the next target groups within the Phase One priority population have been identified:
- Staff and essential caregivers in long-term care homes, high-risk retirement homes, First Nations elder care home and any residents who have not received a dose
- Alternative level of care patients in hospitals who have an admission to a long-term care home, retirement home or other congregate care home
- “Highest priority” and “very high priority” health-care workers (see COVID-19: Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination (MOH, February 9, 2021)).
- Indigenous adults in northern remote and high-risk communities
(once all those identified as “immediate priority” have been addressed)
- Adults aged 80 and older
- Staff, caregivers and residents in retirement homes and other congregate settings for seniors
- “High priority” healthcare workers (see COVID-19: Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination (MOH, February 9, 2021)).
- All Indigenous adults
- Adults receiving chronic home care
Phase 1 (December – end of March)
Approximately 1.5 million long-term care residents, staff, and other employees; health care workers; adults in First Nations, Métis, and Inuit populations; adult chronic home care recipients
Phase 2 (End of March – end of July)
8.5 million essential workers, adults (75+, 60-75), at-risk populations, followed by adults 16-60
Phase 3 (August and beyond)
Remaining eligible Ontarians
Adapted from: Government of Ontario, January 2021
Ontario’s vaccination schedule will be impacted by manufacturing and supply chain delays. To mitigate the effects of the delay, the province will:
- Accelerating vaccination of the most vulnerable populations across Ontario (long term care, high risk retirement and First Nations elder care residents) with the goal of visiting each home in the province to administer first doses by February 10, pending delivery dates the first week of February.
- Extending the interval between doses of the Pfizer vaccine in some situations to ensure that everyone who has had a first shot will have access to their second. Residents of long-term care, high-risk retirement and First Nations elder care homes who have received their first dose of the Pfizer vaccine will receive a second dose in 21 to 27 days. All others who receive the Pfizer vaccine will receive their second dose between 35 and 42 days after the first.
Forecasted vaccine allocation to Ontario
As of February 11, 2021, Ontario has received 205,725 doses of the Pfizer-BioNTech vaccine and 104,700 doses of the Moderna vaccine (523,675 total doses). The following tables show the number of vaccines that are forecasted to be available in Ontario in the coming weeks. Amounts may fluctuate, and the numbers will be updated as quantities and timing of deliveries are confirmed.
Mar 29-Apr 4
Mar 29-Apr 4
Public Health Units will lead local vaccination distribution, with hospitals continuing to lead vaccination of hospital-based physicians and healthcare workers. The 34 Public Health Units in the province are in the process of identifying primary care vaccination leads.
Local COVID-19 vaccine rollout is being led by public health units (PHUs) in partnership with health and municipal sectors. Although most PHUs are still in the planning phase for mass vaccination, some have released their vaccination plans:
- Grey Bruce Health Unit
- Middlesex-London Health Unit
- Ottawa Public Health
- Peel Public Health
- Peterborough Public Health
- Region of Waterloo Public Health
- Renfrew County and District Health Unit
- Sudbury & Districts Public Health
- Toronto Public Health
- Wellington-Dufferin-Guelph Public Health
- Windsor-Essex Country Health Unit
- York Region Public Health
If you are interested in supporting vaccine rollout in your area, contact your public health unit, and consider sharing Partnering with primary care for local COVID-19 vaccine rollout in Ontario: A practical guide, a resource created by AHC, AFHTO, IPHCC, SGFP, NPLCA, OCFP and endorsed by the Provincial Primary Care Advisory Table.
Vaccine clinics are currently not open to the public. Additional hospital sites and Public Health Units will be opened to provide vaccines in regions with the highest rates of COVID-19 infection. Clinic locations:
- Brantford General Hospital
- Grand River Hospital
- Halton Healthcare
- Hamilton Health Sciences
- Humber River Hospital
- Kingston General Hospital
- Lakeridge Health
- London Health Sciences Centre
- Mackenzie Health
- Michael Garron Hospital
- Niagara Health – St. Catharines site
- Ottawa Hospital
- Royal Victoria Regional Health Centre
- Scarborough Health Network
- Southlake Regional Health Centre
- Sunnybrook Health Sciences Centre
- Thunder Bay Regional Health Sciences Centre
- Trillium Health Partners
- University Health Network in Toronto
- Unity Health Toronto
- William Osler Health System
- Windsor Regional Hospital
Metro Toronto Convention Centre “Proof-of-Concept” site
Under the direction of the Ministry of Health, Toronto and Toronto Public Health launched a ‘proof-of-concept’ immunization clinic on Monday, January 18, 2021. The clinic temporarily shut down after 2 days due to delays in the delivery of the Pfizer-BioNTech vaccine. On Monday, February 15, 2021, the clinic re-opened to administer second doses to the 378 healthcare workers who received their first dose back in January. All eligible healthcare workers received appointment times and there is no opportunity for additional vaccinations.
The clinic was launched to help test and adjust immunization clinic setup in non-hospital settings, ensuring safety and increasing efficiency in advance of wider immunization (City of Toronto, January 11, 2021).
The goals of this site are:
- Vaccination of 250 people per day, in accordance with provincial allocations of COVID-19 vaccine
- Test clinic operations with a sample group of healthcare workers, identified in accordance with the Province’s Ethical Framework for COVID-19 vaccine prioritization, including frontline shelter workers and harm-reduction and Streets to Homes staff who support some of Toronto’s most vulnerable residents.
- Develop a clinic playbook collaboration with provincial and hospital partners after 6 weeks of operation, to be provided to the province for use in establishing other immunization clinics both in Toronto and across Ontario.
In future phases, the province will establish other clinic types in order promote swift vaccination:
- On-site clinics for northern and remote First Nation communities, on-reserve Indigenous residents, and adult chronic home care recipients
- Mobile sites for congregate living facilities and urban Indigenous communities
For greater detail about vaccine rollout, prioritization, and availability, see:
- Getting a COVID-19 vaccine in Ontario (Government of Ontario, January 2021)
- Vaccines and treatments for COVID-19: Vaccine rollout (Health Canada)
- COVID-19 Vaccination Update Technical Briefing (Government of Ontario, January 13, 2021)
- Vaccine Availability and Rollout (MOH, January 6, 2021).
- COVID-19 vaccines for Ontario (Government of Ontario, 2021).
- Guidance for Prioritizing Health Care Workers for COVID-19 Vaccination (MOH, February 9, 2021)
- Ethical framework for COVID-19 vaccine distribution (Government of Ontario, January 11, 2021)